Psychotic Disorders Flashcards
Definition of psychotic disorders
Conceptualised in terms of spectrum of severity
5 diverse symptom dimensions
- delusions
- hallucinations
- disorganised thinking
- grossly disorganised/abnormal motor behaviour
- so called negative symptoms
Positive symptoms (addition of disturbance) Negative symptoms (deficits in psychological processes)
Hallucination
Perception like experience
Clarity & impact of true perception
Absence of external stimuli
75% of schizophrenia patients report
Delusions
Belief not consistent with what most others believe
Even with proof to the contrary
- paranoid (someone seeks to harm)
- reference (message conveyed by external sources tv etc)
- somantic (body beliefs)
- grandiose (inflates view of self)
- religious (themes)
- nilhilistic or guilt (self dead or self/environment ceased to exist)
- jealousy or erotomanic (false infidelity)
- passivity phenomena (thinking under control of another)
Disorganised thinking
‘Formal thought disorder’
Disturbance in logical sequencing of coherence and thought
Grossly disorganised behaviour
Catatonia
Decrease in reactivity to the environment
Negative symptoms
Deficits in speech, emotions and spontaneous behaviour
Alogia - decreased speech
Affective flattening - lack of emotional expressiveness with possible subjective loss of emotional experience
Schizophrenia
Diagnosis
2 or more symptoms present for significant proportion of time during 1 month period
Continuous signs consistently present for at least 6 months
Associated features
- depression
- anxiety & trauma-related problems
- substance misuse
- quality of life
- stigma & social isolation
Kraepelin
‘Dementia praecox’ aka schizophrenia
Who coined term schizophrenia
(Schizein) Split
(Phren) Mind
Eugen Bleuler
Who identified symptoms of schizophrenia
Kurt Schneider
Schizophrenia
Epidemiology
Lifetime prevalence 1-2%
Phases
- Premorbid (risk factor presence)
- Prodromal (change preceding symptoms)
- Acute (intensified symptoms)
- Early Recovery (depression/anxiety)
- Late Recovery (reintegration)
- Enduring psychosis
Schizophrenia
Aetiology
Genetic
Gene environment
Neurotransmitters
Brain structure - enlarged ventricles & prefrontal cortex
Morrison
Cognitive model
Mood & psychological disturbance
Cognitive & behavioural responses
Intrusion into awareness
Culturally acceptable interpretations of intrusions
Life experiences
Faulty knowledge regarding self and others
Tardive dyskinesia
Side effect - involuntary facial movements
Schizophreniform disorder
Disturbance less than 6 months
